By Lisa Jarrell
“Yoga teaches us to cure what need not be endured and endure what cannot be cured.” B.K.S. Iyengar
Major Depressive Disorder is an illness that affects 14.8 million American adults each year and is the leading cause of disability for people ages 15-44. Depression frequently occurs with anxiety disorders, which affect forty million American adults each year. Many of those affected by depression turn to yoga for relief. Asana, pranayama, and meditation practice can reduce stress response, alleviate tension in the body, and help the depressed or anxious person make positive life changes to lessen or eliminate anxiety and depression.
According to Western medicine, depression is the result of an imbalance in neurotransmitters dopamine and serotonin in the brain. People who are depressed experience chronic activation of the sympathetic nervous system. Since the fight or flight response is always turned on, there is an excess of the stress hormone cortisol in the bloodstream. Yogic philosophy views depression differently, positing that separation of people from one another and from themselves causes suffering and ignorance of one’s true nature as part of the Universal Whole. The pain of depression is the result of a false identification with our external selves and experiences. Yoga asana, pranayama, and meditation reintegrate the self and help the person realize his/her connection to the Universal Whole. Yoga practice also has a physiological response on the body, helping to calm the nervous system and relax tension held in the body.
The number of research studies involving yoga and depression has increased in recent years. Reviews of these studies indicate that regular yoga practice can improve the symptoms of depression. Yoga can help modulate stress response, decrease heart rate, slow the breath, and lower blood pressure. In a 2008 study at the University of Utah, researchers found that yoga practitioners had higher pain tolerance and lower pain-related brain activity than non-practitioners. The researchers also were able to link a poorly regulated stress response to a lower pain threshold.
Yoga has been shown in several controlled studies to improve mood, lessen tension and relieve anxiety, depression, anger, hostility, and fatigue. According to a study at Benares Hindu University in Vanasari, India, people suffering from depression that established and maintained a regular asana practice for three to six months reported improved mood and daily functioning. According to a study conducted at UCLA, back bends, vigorous standing asanas, and inversions were found to significantly reduce symptoms of depression, including fatigue and anxiety.
While results of these studies are convincing, the real proof of yoga’s effectiveness is personal experience. As someone who has personally struggled with depression since her late teens, I’ve experienced the healing power of yoga. In particular, the Iyengar style of yoga has been beneficial in alleviating my depression. The Iyengar style of hatha yoga does not address the emotional body as some styles of yoga do. However, the practice soothes and calms the mind and emotions through the practice of physical postures. The attention to posture and alignment required by Iyengar yoga leaves little time for the mind to wander to obsessive or anxious thoughts. The style can be vigorous or gentle depending on the needs of the practitioner at any given time.
Iyengar-trained yoga teacher Patricia Walden has worked with students to minimize the effects of depression through yoga for many years. In her work, she characterizes depression as either rajasic or tamasic. Rajasic depression is characterized by agitation, anxiety, and, rapid breathing, and quickness to anger. People with tamasic depression are lethargic, apathetic, and lacking energy. Their breath tends to be shallow, with a short inhalation. The type of symptoms exhibited determines the type asana, pranayama, and meditation practices that will be most beneficial.
Rajasic depression requires an asana practice that is calming, cooling and able to help the mind slow down. Seated asanas are beneficial, helping to quiet the mind and relax the body. Seated forward bends like Paschimothanasana and Janu Sirsasana calm the brain and relieve mild fatigue and headache. These asanas and others similar to them encourage contemplation, relaxation, and can counteract the frenetic feelings of rajasic depression. The Moon Salutation, a vinyasa developed by Kripalu teachers, benefits rajasic depression; it is calming, soothing, and encourages a feeling of groundedness. Though not of Iyengar origin, the sequence can be done with great attention to movement and helps to calm the mind.
In contrast to the lethargy of rajasic depression, tamasic depression is best alleviated with a more active and energizing practice. Vigorous standing poses and challenging vinyasas help to increase energy flow in the body. The standing asanas, including Tadasana, Trikonaska, and Vibrahadrasana II, energize the body. Supine poses and backbends such as Wheel Pose, Bridge Pose, and Upward Facing Dog pose require opening the chest and lifting the heart chakra. They alleviate stress; reducing anxiety, and combating fatigue. Any of the many versions of the Sun Salutation increases energy and heat in the body and improves fatigue. Challenging vinyasas like this encourage mindful movement and deep breathing. Continuous movement is more important for tamasic students. The rhythm of the vinyasa and the focus on the breath combats the lethargy and sluggishness of tamasic depression.
These basic guidelines are helpful for moving energy in a helpful direction. However, prescribing specific asanas is complicated by the individual needs of the depressed person and the nature of the symptoms exhibited. It is important to keep in mind that each individual case of depression is unique and each yoga practice will be different based on how the person is feeling on any given day. Generally speaking, however, inversions are helpful for both rajasic and tamasic depression because they increase blood flow to the brain. As the brain is washed in blood, it also receives extra oxygen and glucose, the building blocks of neurotransmitters. Thus the brain is better able to produce serotonin, dopamine, and norepinephrine in order to restore chemical balance to the body. Inversions also strengthen muscles in the neck and spine, helping to improve posture and mood.
Modifying the breath to focus on either the inhalation or the exhalation can shift the practice to energizing or to calming. The sympathetic nervous system is stimulated by deep and prolonged inhalation. The result is a temporary increase in heart rate and blood pressure. Deep and prolonged exhalation has the opposite effect; stimulating the parasympathetic nervous system. The result is in a temporary drop in heart rate and blood pressure. Like asana, pranayama practice can also be tailored to either energize tamasic depression or to calm rajasic depression. Nadi Sodhana, or Alternate Nostril Breath, is a calming pranayama that stills the mind. The practice produces feelings of groundedness and balance, and ability to focus. Nadi Sohana is beneficial for rajasic or tamasic depressive feelings.
Like asana and pranayama, meditation is beneficial for depression. It can help calm the mind and release negative or repetitive thoughts that cause anxiety. Meditation can also reveal samskaras, or thought patterns, that may be hindering recovery. Observation of thoughts during meditation helps to clarify one’s perceptions. Through meditation practice, one can see how reactions to present circumstances are often based on thought patterns ingrained in our minds from past situations. The self-awareness gained through meditation can help remove obstacles and free the depressed person from perceived limitations and damaging behavioral patterns.
For those suffering from rajasic depression, relaxation and meditation practice can be the most challenging part of a yoga class or practice. Savasana in particular was the most difficult time of yoga class when I first began practicing. Meditation is also challenging for people suffering from depression. Both require sitting with your feelings and at the same time allowing them to pass. For those with severe symptoms, keeping the eyes open during relaxation can be helpful. Limiting the time spent in meditation, or focusing attention on a word or phrase can help keep obsessive thoughts at bay. Over time as symptoms begin to lessen, one can begin to focus on identifying and changing damaging thought patterns.
As a person who has battled depression since my late teens, I have come to understand how the practice of asana, meditation, and pranayama can help stabilize mood and reduce anxiety. I have practiced the Iyengar style of yoga for 8 year and have found significant improvement in my symptoms. The rhythm of breath, the concentration on alignment in asana, and the physical release of tension held in the body all have helped me immeasurably. Coming to the mat for each practice is a way to overcome the inertia created by depression. The very act of practicing even a few minutes each day can improve attitude and mood. Even the smallest step can lead to the next step, and eventually to healing.
National Institutes of Health. The Numbers Count: Mental Disorders in America.. NIH, 2008. http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml#MajorDepressive Accessed 8/2/09.
McCall, Timothy. Yoga As Medicine: The Yogic Prescription for Health and Healing. New York: Bantam, 2007: 265.
Ware, Christine Jeuland. “Yoga and Psychotherapy” Yoga Therapy in Practice. June 2007: 15.
Harvard Mental Health Letter. Harvard Health Publications, April 2009: 4.
Ibid.
McCall, 266-267.
McCall, 266.
McCall, 266.
Liebler, Nancy Cullen and Sandra Moss. Healing Depression the Mind-Body Way: Creating Happiness Through Meditation, Yoga, and Ayurveda. Wiley, 2009: 182-184
McCall, 266.
Weintraub, Amy. “The Natural Prozac” Yoga Journal Online http://www.yogajournal.com/health/133 Accessed 5/22/09.
Lindsay, Jamie. “The Energetic Effects of Pranayama” Yoga Journal Online. http://www.yogajournal.com/practice/1411. Accessed 8/2/09.
Ibid.
Weintraub, 126.
Weintraub, Amy. Yoga For Depression: A Compassionate Guide to Relieve Suffering Through Yoga. New York: Broadway Books, 2004: 172-173.
Lisa Jarrell is a Yoga Teacher Training intern. She will be teaching Yoga classes in the Pendleton, Indiana area.
By Dr. Paul Jerard, E-RYT 500